Immunology

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Controlling healthcare-associated infections: the role of infection control and antimicrobial use practices

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Abstract

Healthcare-associated infections are a major cause of morbidity and mortality in pediatric patients in the United States and throughout the world. Overall rates of infection range widely depending on the pediatric population, with the highest rates being in patients in neonatal intensive care units, followed by those in pediatric intensive care units, immunocompromised patients, and those undergoing surgical procedures.… Read more

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Peripheral blood cell-specific cytokines in persons with untreated HIV infection in Malawi, Africa

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Abstract

Human immunodeficiency virus (HIV) infection is the primary cause of morbidity and mortality in Malawi, Africa, because of its many effects on the immune system. Immune cells communicate through cytokines; therefore, we examined the relationships between HIV serostatus and cell-specific cytokine production for 40 asymptomatic, employed adults and 312 acutely ill, hospitalized patients in Malawi.… Read more

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Demographic and immune correlates of human herpesvirus 8 seropositivity in Malawi, Africa

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Abstract

BACKGROUND: In the USA, human herpesvirus 8 (HHV-8) is associated with Kaposi’s sarcoma (KS) and HIV infection. We examined HHV-8 seroprevalence in a Malawian cohort, and assessed its relationship with HIV, KS, demographic characteristics, and immune findings.

METHODS: In 1997 and 1998, blood samples were obtained from 272 hospitalized Malawian patients, for whom demographic information was obtained, and 24 healthy volunteers without demographic data.… Read more

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Clinical and immune impact of Mycobacterium bovis BCG vaccination scarring

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Abstract

The World Health Organization recommends Mycobacterium bovis BCG vaccination in areas of high tuberculosis prevalence. BCG’s clinical and immune effects, not necessarily Mycobacterium tuberculosis specific, are unclear. BCG vaccine scarring often is used as a surrogate marker of vaccination or of effective vaccination.… Read more

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Automated Evaluation of AIDS Messages with Highā€Risk, Lowā€Literacy Audiences

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Abstract

A series of televised public service announcements (PSAs) about acquired immune deficiency syndrome (AIDS) was evaluated with 100 black participants attending a Sexually Transmitted Diseases Clinic in Atlanta, Georgia. Since the literacy level of the participants was suspected to be low, questions were administered orally and an electronic data collection technique was used which permitted the participants to push buttons, as opposed to speaking or writing responses.… Read more

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Spontaneous cytokine production and its effect on induced production

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Abstract

Cytokines regulate cellular immune activity and are produced by a variety of cells, especially lymphocytes, monocytes, and macrophages. Multiparameter flow cytometry is often used to examine cell-specific cytokine production after in vitro phorbol 12-myristate 13-acetate and ionomycin induction, with brefeldin A or other agents added to inhibit protein secretion.… Read more

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Vitamin A levels and immunity in humans

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Abstract

In animal studies, vitamin A deficiency induces a shift from type 2 (humoral, Th2) to type 1 (cellular, Th1) cytokines; there are no similar data for humans. Control of human immunodeficiency virus (HIV) and Mycobacterium tuberculosis infections requires type 1 cytokine (cellular) immunity.… Read more

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Age-related differences in cell-specific cytokine production by acutely ill Malawian patients

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Abstract

Age-related changes in human cell-specific cytokine responses to acute illness have not been well examined. We therefore evaluated age-related differences in T, B and natural killer (NK) peripheral blood lymphocyte cytokine responses of 309 acutely ill hospitalized people in Malawi, Africa, < 1 month-61 years of age.… Read more

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The effects of iron deficiency on lymphocyte cytokine production and activation: preservation of hepatic iron but not at all cost

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Abstract

Worldwide, over 40% of children have iron deficiency anaemia, frequently associated with infections. Certain cytokines are involved in both immune activation/response to infection and iron transport/metabolism. We therefore assessed the relations among iron deficiency, cytokine production and lymphocyte activation markers in 142 hospitalized Malawian children.… Read more

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Comparison of serum and cell-specific cytokines in humans

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Abstract

Cytokines function at the cellular, microenvironmental level, but human cytokine assessment is most commonly done at the macro level, by measuring serum cytokines. The relationships between serum and cellular cytokines, if there are any, are undefined. In a study of hospitalized patients in Malawi, we compared cytometrically assessed, cell-specific cytokine data to serum interleukin 2 (IL-2), IL-4, IL-6, IL-8, IL-10, gamma interferon (IFN-gamma), and tumor necrosis factor alpha (TNF-alpha) levels in 16 children and 71 (IL-2, -4, -6, -10) or 159 (IL-8, IFN-gamma, and TNF-alpha) adults, using Wilcoxon rank sum tests and Pearson’s (r(p)) and Spearman’s (r(s)) rank correlations.… Read more

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Intracellular cytokines in the acute response to highly active antiretroviral therapy

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Abstract

OBJECTIVES: Successful highly active antiretroviral therapy (HAART) is usually associated with a rapid decline in HIV plasma RNA levels and a gradual increase in CD4 T cells. We examined whether changes in cytokine production and profile precede other immunological changes and whether these might occur in temporal association with plasma HIV RNA changes.… Read more

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Cytokines and malaria parasitemia

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Abstract

The balance between pro- and antiinflammatory cytokines may be important in malaria presentation and outcome. Malaria tends to be more severe in children than in adults, presumably because partial immunity develops with age. However, the full nature of, and age-related differences in, anti-malarial immunity are unknown.… Read more

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Modulation of CD8 and CD3 by HIV or HIV antigens

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Abstract

To investigate whether human immunodeficiency virus (HIV)-1 and HIV-1 antigens modulate surface and cytoplasmic CD8 or CD3, as well as CD4, we used cell permeabilization reagents, surface/cytoplasmic fluorescent staining, multiparameter flow cytometric techniques and an in vitro culture system in which relatively few lymphocytes are actively infected with HIV.… Read more

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Effects of HIV-1 peptides on T-cell receptor variable beta chain families

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Abstract

Superantigens (SAGs) selectively stimulate expansion and then deletion of specific T cell antigen receptor (TCR) variable beta chain (Vbeta) families. We investigated six synthetically produced HIV-1-related peptides for evidence of SAG activity: three derived all or in part from the transmembrane gp41 protein and three from the genetic sequence of the tRNA binding region.… Read more

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Natural T, gammadelta, and NK cells in mycobacterial, Salmonella, and human immunodeficiency virus infections

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Abstract

NK cells, gammadelta T cell antigen receptor chain-positive cells, and CD3(+)CD16/56(+) (natural T [NT]) cells are involved in innate immunity and immunoregulation; however, their role in clinical infection is not well defined. Cytofluorometric analysis was used to examine peripheral blood from bacteremic, nonbacteremic, and healthy human immunodeficiency virus (HIV)-positive and -negative persons in Malawi, Africa.… Read more

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Mitogen-induced modulation of CD3, CD4, and CD8

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Abstract

It is not clear whether CD3 contacts CD4 or CD8 directly, nor have the regulation and interregulation of expression of these three receptor molecules been determined. We explored these issues by first stimulating human peripheral blood lymphocytes in vitro with three well-characterized T-cell receptor-directed mitogens (phytohemagglutinin [PHA], concanavalin A [ConA], and anti-CD3 monoclonal antibody [anti-CD3]) and then using multiparameter flow cytometric techniques to investigate modulation of surface (sur) and cytoplasmic (c) CD3, CD4, and CD8.… Read more

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Increased expression of CD80 and CD86 in in vitro-infected CD3+ cells producing cytoplasmic HIV type 1 p24

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Abstract

Determining the effects of HIV infection on the expression of cell surface molecules has been limited by an inability to differentiate between productively infected cells and those without productive infection. We inoculated human peripheral blood mononuclear cells from healthy, human immunodeficiency virus type 1 (HIV) antibody-negative donors with HIV; noninoculated cells were also examined.… Read more

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Immune determinants of organism and outcome in febrile hospitalized Thai patients with bloodstream infections

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Abstract

Opportunistic infections (OI) and the human immunodeficiency virus (HIV) cause significant morbidity and mortality in developing countries. Immune cell and cytokine profiles may be related to the type and course of OI and to the OI-HIV interaction. Examining cell-specific cytokine production ex vivo has only recently become feasible.… Read more

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Kawasaki disease and the T-cell antigen receptor

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Abstract

We investigated the evidence for an infectious etiology of Kawasaki disease (KD), an acute vasculitis of unknown etiology, by assessing the effects of KD on the T cell antigen receptor variable beta region families (V beta). Using 3-color flow cytometry, we studied KD patients pre- and post-intravenous gamma globulin (IVIG) therapy and at > 40 days post therapy, additionally comparing them to matched pediatric control patients (PCC) and their own healthy parents (one parent/KD child).… Read more

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Immunoregulatory changes in Kawasaki disease

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Abstract

Kawasaki disease (KD) is an acute vasculitis of unknown etiology, occurring in young children and treated with intravenous gamma globulin (IVIG) to prevent significant cardiac morbidity and mortality. We studied KD patients pre- and post-IVIG therapy and at >40 days posttherapy, additionally comparing them with matched pediatric control patients and parents.… Read more

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Single-cell cytokine profiles in normal humans: comparison of flow cytometric reagents and stimulation protocols

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Abstract

Cytokines are produced and function at a micro environmental level: intracellular assessment has only recently become practically feasible. We used 3-color flow cytometry to examine surface and cytoplasmic antigens on peripheral blood lymphocytes of 18 normal donors, assessing the applicability/comparability of various directly conjugated anti-human cytokine reagents and stimulation protocols using separated cells or whole blood preparations.… Read more

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HIV antigens and T-cell receptor variable beta chain families

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Abstract

The authors investigated whether the human immunodeficiency virus (HIV) has restrictive effects on the variable region of the beta chain (V beta) of the T-cell antigen receptor (TCR), by in vitro cultivation of non-HIV-infected peripheral blood lymphocytes with one of six HIV antigens or heat-inactivated whole virus (HIV-HI).… Read more

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The effects of mitogens, IL-2 and anti-CD3 antibody on the T-cell receptor V beta repertoire

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Abstract

Phytohaemagglutinin (PHA), Concanavalin A (Con A), interleukin-2 (IL-2), and monoclonal antibodies to CD3 (CD3MoAbs) are used for the assessment of the T-cell receptor (TCR) BV gene family expression in autoimmune disorders and multiple sclerosis, and to produce clones for assessment of cytokine profiles in progressive human immunodeficiency virus infection.… Read more

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The epidemiology of colonization

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Abstract

Colonization is the presence of a microorganism in or on a host, with growth and multiplication but without any overt clinical expression or detected immune response in the host at the time it is isolated. Normal colonization in humans begins during the birth process and through subsequent contacts with the inanimate or animate environments until a delicately balanced “normal” flora is established; subsequently, the precise components of this flora evolve.… Read more

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Evidence for a shift from a type I lymphocyte pattern with HIV disease progression. Hemophilia Growth and Development Study

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Abstract

Whether a shift from a type I (cell mediated) immune profile occurs with progressive HIV-related immune dysfunction is a matter of heated debate.

We analyzed data for 333 HIV antibody-positive (HIV+) and -negative (HIV-) hemophilic children/adolescents, to examine whether the relationships among immunologic parameters and vaccine-related serology supported a shift with advancing HIV infection.… Read more

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Immune and serologic profiles of HIV-infected and noninfected hemophilic children and adolescents. Hemophilia Growth and Development Study Group

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Abstract

OBJECTIVES: To assess relationships among the effects of HIV on hemophilic children and adolescents’ immunologic parameters and vaccine-related serology.

METHODS: We analyzed data from extensive baseline immunologic evaluations of 207 HIV antibody-positive (HIV+) and 126 HIV antibody-negative (HIV-) hemophilic children and adolescents.… Read more

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Hemophilia growth and development study. Design, methods, and entry data

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Abstract

PURPOSE: The study design, research questions, and baseline data are presented from a multicenter longitudinal epidemiologic investigation of the impact of human immunodeficiency virus (HIV) infection on three areas of functioning in children and adolescents with hemophilia: physical growth and sexual maturation, immune function, and neurological and neuropsychological functioning.… Read more

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Using indices to differentiate dimensions of knowledge regarding modes of HIV transmission in the U.S. population, 1987-1989

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Abstract

The number of HIV-infected individuals is increasing, making it important for the public to understand not only how HIV is transmitted but also the lack of transmission risk associated with casual contact. Using CDC’s National Center for Health Statistics National Health Interview Survey, we divided modes of transmission items into two areas of knowledge: “True Transmission” and “False Transmission.”… Read more

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Abuse, neglect, and the HIV-infected child

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Abstract

The effect of HIV on child abuse prevention must be considered on three different levels. The first consists of indirect effects: the extent to which this infection will be a burden on the health care, social service, and public assistance systems in this and other countries, leading to decreasing resources for child abuse prevention. Ā Ā … Read more

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Relationship of partially purified factor concentrates to immune tests and AIDS. The Hemophilia-AIDS. Collaborative Study Group

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Abstract

We evaluated those members of a cohort of 203 hemophilic men providing all necessary information at their 1984 and 1985 evaluations, to determine whether non-heated or less than 80 degrees C dry heat-treated partially purified factor products were associated with 1) the development of AIDS in human immunodeficiency virus (HIV)-infected persons or 2) abnormal immune test results in participants seroconverting or remaining HIV seronegative.… Read more

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Age and human immunodeficiency virus infection in persons with hemophilia in California

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Abstract

Thirteen hemophilia centers provide comprehensive care to approximately 90 percent of persons with hemophilia in California. For 1987, these centers reported patient human immunodeficiency virus (HIV) antibody status, age group, level of clotting factor deficiency, and hemophilia type on 1,438 persons with hemophilia A and B; HIV serologic status was known for 860 persons (59.8 percent) of whom 537 (62.4 percent) were HIV-antibody-positive.… Read more

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Concordance of polymerase chain reaction with human immunodeficiency virus antibody detection

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Abstract

To evaluate the correlation of detection of human immunodeficiency virus (HIV) by polymerase chain reaction (PCR) with detection of HIV antibody, 271 simultaneous serum and peripheral blood mononuclear cell samples were examined from 242 persons whose activities placed them at increased risk for HIV infection: 142 from homosexual men, 86 from hemophilic men, and 43 from heterosexual partners of HIV-infected persons.… Read more

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Foodborne Snow Mountain agent gastroenteritis with secondary person-to-person spread in a retirement community

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Abstract

A variety of small round-structured viruses are being recognized with increasing frequency as a cause of gastroenteritis in the community, but have rarely been reported to cause outbreaks in hospitals or extended-care facilities. From March 20 through April 15, 1988, an outbreak of gastroenteritis occurred in a retirement facility in the San Francisco Bay area.… Read more

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Pregnancies in human immunodeficiency virus-infected sex partners of hemophilic men. The Hemophilia-AIDS Collaborative Study Group

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Abstract

We investigated 24 completed pregnancies of 20 healthy, human immunodeficiency virus (HIV)-seropositive sex partners of 20 seropositive hemophilic men. One woman had recurrent herpes simplex type 2 infection; no woman was known to use illicit drugs or to have other purported cofactors for vertical HIV transmission.… Read more

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Absence of human T-cell lymphotropic virus type I coinfection in human immunodeficiency virus-infected hemophilic men

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Abstract

Concern for transmission of human T-cell lymphotropic virus, type 1 (HTLV-1) infection to recipients of infected cellular blood products has prompted development of tests to eliminate blood units with HTLV-I antibodies. Most hemophilic men from the United States became infected with human immunodeficiency virus (HIV) before HIV donor screening and before blood products were processed to inactivate the virus.… Read more

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Prevalence of human immunodeficiency virus type 1 DNA in hemophilic men and their sex partners. Hemophilia-AIDS Collaborative Study Group

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Abstract

Polymerase chain reaction (PCR) was used to detect human immunodeficiency virus (HIV)-1 DNA in peripheral blood mononuclear cells to assess in hemophilic men whether any were HIV-seropositive but uninfected or seronegative but infected and in seronegative sex partners of seropositive hemophilic men whether any were infected.… Read more

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Geographic variability of hemophilia-associated AIDS in the United States: effect of population characteristics. Hemophilia-Associated AIDS Study Group

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Abstract

National AIDS surveillance suggests that approximately 3.5% of all hemophilic patients in the United States have developed AIDS as of February 1988; however, the cumulative incidence of AIDS among seropositive patients at individual hemophilia treatment centers (HTCs) has been reported to be as high as 12%.… Read more

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Duration of human immunodeficiency virus infection before detection of antibody

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Abstract

To estimate the duration and frequency of the period of HIV infection without detectable antibody, modelling techniques were applied to results of detection of HIV DNA by means of the polymerase chain reaction (PCR) and to data from cases in published reports. Ā … Read more

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Infectious disease-related deaths of low birth weight infants, United States, 1968 to 1982

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Abstract

Infant mortality rates in the United States are higher than in any other developed country. Low birth weightĀ (LBW) is the primary determinant of infant mortality.

 

Despite city, state, and federal programs to prevent LBW, decreases in infant mortality in the 1980s appear to be largely secondary to improved survival of LBW infants rather than to a decline in the rate of LBW births.… Read more

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HIV and hemophilic children’s growth

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Abstract

The acquired immune deficiency syndrome (AIDS) often has profound effects on growth; however, the effects of human immunodeficiency virus (HIV) on asymptomatic children’s growth are unknown. Before heat inactivation/HIV donor screening of factor concentrates, many hemophilic children became infected with HIV.… Read more

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Human immunodeficiency virus infection in hemophilic children

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Abstract

The following groups were compared: (1) children less than 18 years old who have hemophilia-associated acquired immunodeficiency syndrome (AIDS) with other children with AIDS and with adults who have hemophilia-associated AIDS and (2) asymptomatic HIV-infected hemophilic children with asymptomatic HIV-infected hemophilic adults.… Read more

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Description of case-mix adjusters by the Severity of Illness Working Group of the Society of Hospital Epidemiologists of America (SHEA)

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Abstract

Hospitals, insurance companies, and federal and state governments are increasingly concerned about reducing patient cost expenditures while maintaining high quality patient care. One method of reducing expenditures has been to tie hospital reimbursement with a prospective payment system based on diagnosis-related groups (DRGs).… Read more

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Racial differences in care of patients with hemophilia

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Abstract

Hemophilia treatment centers were first established in the midĀ­-1970s to provide optimal and coordinated medical care to patients with the disorder. Our study suggests that blacks with hemophilia may be receiving less coordinated care and less appropriate bloodĀ­ product therapy than whites with hemophilia.… Read more

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Potential effect of revising the CDC surveillance case definition for AIDS

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Abstract

The Centers for Disease Control (CDC) revised the surveillance case definition for acquired immunodeficiency syndrome (AIDS) in August, 1987. To determine the impact of this revision, information was extracted from the medical charts of the 630 patients receiving comprehensive medical care as of 1980 at 6 haemophilia treatment centres, and who were therefore likely to have been infected with human immunodeficiency virus (HIV).… Read more

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An outbreak of necrotizing enterocolitis. Association with transfusions of packed red blood cells

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Abstract

Of 187 newborns admitted to a 33-bed, level III neonatal intensive care unit between January 1, 1985 and June 23, 1985, 33 developed necrotizing enterocolitis during their hospital stay. Twenty of the 33 newborns (61%) had onset of symptoms between April 1 and June 23, suggesting clustering during this period.… Read more

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The Epidemiology of AIDS

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Abstract

Cases of the acquired immune deficiency syndrome (AIDS) were first reported in June and July of 1981, as clusters of Kaposiā€™s sarcoma and Pneumocystis cariniiĀ pneumonia among homosexual men. Since then, epidemiologic surveillance has been used by investigators and public health professionals to identify that an outbreak existed, to characterize the outbreak, and to determine and predict its extent and course.… Read more

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Hemophiliac patient’s knowledge and educational needs concerning acquired immunodeficiency syndrome

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Abstract

The Patient Knowledge Assessment Study (PKAS) was conducted among 107 male hemophilic patients, aged 15 to 67 years, at 19 hemophilia treatment centers (HTC). Participants were given a 30-item questionnaire concerning the cause of acquired immunodeficiency syndrome (AIDS), the groups at risk, and modes of transmission.… Read more

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Infectious diseases: preventable causes of infant mortality

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Abstract

After almost a century of improvement, the rate of decrease in US infant mortality rates began to level off during the period of 1982 to 1984. Rates actually increased in some states. Because much of the decline in infant mortality in this century can be attributed to advances in infectious disease treatment and prevention programs, we evaluated the current impact of infectious diseases on infant mortality.… Read more

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The course of the epidemic of acquired immunodeficiency syndrome in the United States hemophilia population

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Abstract

The time course of the epidemic of acquired immunodeficiency syndrome (AIDS) as it has occurred in the US hemophilia population is examined using surveillance data collected by the Centers for Disease Control (CDC). These data indicate that the epidemic course in hemophiliacs is distinguishable from that in the homosexual/bisexual and intravenous drug-using populations in at least one respect–the epidemic in the hemophilia population is characterized by a lack of consistent increase in the number of new AIDS cases in successive time intervals.… Read more

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Effects of exposure to factor concentrates containing donations from identified AIDS patients. A matched cohort study

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Abstract

We compared recipients of eight lots of factors VIII and IX voluntarily withdrawn from distribution because one donor was known to have subsequently developed the acquired immunodeficiency syndrome with a nonexposed cohort matched by age, sex, and factor use. The factor VIII recipient cohorts did not differ in prevalence of antibody to human immunodeficiency virus (HIV) (exposed, 75%; nonexposed, 86%), T-cell subset numbers (median: exposed, 619 T-helper cells per cubic millimeter; nonexposed, 659 T-helper cells per cubic millimeter), T-helper to T-suppressor ratios, or immunoglobulin levels.… Read more